{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:13:08Z","timestamp":1784117588742,"version":"3.55.0"},"reference-count":27,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Health & Welfare, Republic of Korea","award":["HC19C0028\u3134\u315c\u3137\u3134\u3147"],"award-info":[{"award-number":["HC19C0028\u3134\u315c\u3137\u3134\u3147"]}]},{"name":"Ministry of Health & Welfare, Republic of Korea","award":["RS-2023-00265165\u3147\u3147"],"award-info":[{"award-number":["RS-2023-00265165\u3147\u3147"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2026,7,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intensive blood pressure (BP) lowering after successful endovascular thrombectomy (EVT) failed to improve functional outcomes, but its association with the extent of blood-brain barrier disruption remains unclear. We investigated whether Contrast Staining-Alberta Stroke Programme Early CT Score (CS-ASPECTS) and contrast staining (CS) after EVT modify the outcomes of post-EVT BP management strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This post hoc analysis of the Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure trial included acute stroke patients who achieved successful EVT and underwent follow-up brain CT within 3\u2009hours of randomisation to intensive (systolic BP &lt;140\u2009mm Hg) or conventional (140\u2013180\u2009mm Hg) BP management. Subgroup analyses were conducted based on CS status and CS-ASPECTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 174 patients (mean age 72.8\u00b112.1 years, 38.5% women), CS was present in 123 (70.7%). CS was associated with a higher rate of any intracranial haemorrhage (ICH) but not with functional outcome. CS-ASPECTS 0\u20136 was associated with a higher risk of symptomatic ICH and worse functional outcome compared with CS-ASPECTS 7\u201310. Among patients with CS-ASPECTS 7\u201310, intensive BP lowering was associated with a lower likelihood of functional independence (adjusted OR 0.37, 95%\u2009CI 0.15 to 0.87), whereas no significant association was observed in patients with CS-ASPECTS 0\u20136 (adjusted OR 1.29, 95%\u2009CI 0.20 to 9.09) (P for interaction=0.044). There was no significant heterogeneity between BP management strategy and CS-ASPECTS for symptomatic intracerebral haemorrhage or mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CS-ASPECTS, but not CS alone, was associated with functional outcome and identified heterogeneity in the association between post-EVT BP lowering and functional independence. These exploratory findings warrant prospective validation before clinical application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04205305\">NCT04205305<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/svn-2026-005132","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:55:11Z","timestamp":1784116511000},"page":"svn-2026-005132","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of intensive blood pressure lowering after endovascular thrombectomy with outcomes according to contrast staining ASPECTS"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct04205305","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-8522","authenticated-orcid":false,"given":"Jae Wook","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2616","authenticated-orcid":false,"given":"Young Dae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6287-6348","authenticated-orcid":false,"given":"JoonNyung","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyungwoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byungjae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Moon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na-Young","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haram","family":"Joo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bang-Hoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Anam Hospital and College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Hwan","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chosun University Hospital, Gwang-Ju, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6112-2939","authenticated-orcid":false,"given":"Hyungjong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kyungpook National University Hospital, Daegu, Daegu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Il","family":"Sohn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Keimyung University College of Medicine, Daegu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-9855","authenticated-orcid":false,"given":"Jeong-Ho","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Keimyung University College of Medicine, Daegu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeseob","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Neurology, Pusan National University School of Medicine, Busan, Busan, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoonkyung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyu Sik","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Young","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hwa","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dong-a University Hospital, Busan, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5551-0273","authenticated-orcid":false,"given":"Sukyoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inje University College of Medicine, Busan, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6733-0683","authenticated-orcid":false,"given":"Jang-Hyun","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Jin","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Pusan National University School of Medicine, Busan, Busan, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Hun","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Ajou University, Suwon, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinkwon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1169-6798","authenticated-orcid":false,"given":"Joonsang","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minyoul","family":"Baik","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yo Han","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gangnam Severance Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-8864","authenticated-orcid":false,"given":"Kwon-Duk","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gangnam Severance Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Ha","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kyungpook National University Hospital, Daegu, Daegu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Guro Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Guk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eulji University Hospital, Daejeon, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul Medical Center, Jungnang-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyoung","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Biostatistics, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kyungpook National University Chilgok Hospital, Buk-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun U","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oh Young","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hoe","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Neurology, CHA University Bundang Medical Center, Seongnam-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-3995","authenticated-orcid":false,"given":"Hyo Suk","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"2026071504550705000_svn-2026-005132v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30483-X"},{"key":"2026071504550705000_svn-2026-005132v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01882-7"},{"key":"2026071504550705000_svn-2026-005132v1.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.14590"},{"key":"2026071504550705000_svn-2026-005132v1.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.14330"},{"key":"2026071504550705000_svn-2026-005132v1.5","doi-asserted-by":"crossref","DOI":"10.1161\/SVIN.123.001287","article-title":"Blood Pressure Management Following Endovascular Stroke Treatment: A Feasibility Trial and Meta\u2010Analysis of Outcomes","volume":"4","author":"Katsanos","year":"2024","journal-title":"SVIN"},{"key":"2026071504550705000_svn-2026-005132v1.6","article-title":"Early intensive blood pressure management after endovascular treatment in ischaemic stroke (IDENTIFY): a multicentre, open-label, blinded-endpoint, randomised controlled trial","volume":"59","author":"Zhang","year":"2025","journal-title":"Lancet Reg Health West Pac"},{"key":"2026071504550705000_svn-2026-005132v1.7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5853\/jos.2023.04119","article-title":"Standard Versus Intensive Blood Pressure Control in Acute Ischemic Stroke Patients Successfully Treated With Endovascular Thrombectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials","volume":"26","author":"Park","year":"2024","journal-title":"J Stroke"},{"key":"2026071504550705000_svn-2026-005132v1.8","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000249"},{"key":"2026071504550705000_svn-2026-005132v1.9","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3988\/jcn.2025.0177","article-title":"Update of the Korean Clinical Practice Guidelines for Stroke: Blood Pressure Management","volume":"21","author":"Jeong","year":"2025","journal-title":"J Clin Neurol"},{"key":"2026071504550705000_svn-2026-005132v1.10","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021640"},{"key":"2026071504550705000_svn-2026-005132v1.11","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1159\/000515410","article-title":"Clinical Significance of Hyperdense Area after Endovascular Therapy in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis","volume":"50","author":"Jiang","year":"2021","journal-title":"Cerebrovasc Dis"},{"key":"2026071504550705000_svn-2026-005132v1.12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.008147"},{"key":"2026071504550705000_svn-2026-005132v1.13","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.1161\/STROKEAHA.124.049494","article-title":"Post-Thrombectomy Flat-Panel CT Contrast Staining ASPECTS and Functional Outcome Prediction","volume":"56","author":"Poggi","year":"2025","journal-title":"Stroke"},{"key":"2026071504550705000_svn-2026-005132v1.14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.123.22617"},{"key":"2026071504550705000_svn-2026-005132v1.15","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.6878","article-title":"Functional Outcomes Associated With Blood Pressure Decrease After Endovascular Thrombectomy","volume":"7","author":"Jung","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026071504550705000_svn-2026-005132v1.16","unstructured":"Nam HS , Kim YD , Choi JK , et al . Outcome in Patients Treated with Intra-arterial thrombectomy: The optiMAL Blood Pressure control (OPTIMAL-BP). Trial Int J Stroke 2021. doi:10.1177\/17474930211041213:17474930211041213"},{"key":"2026071504550705000_svn-2026-005132v1.17","doi-asserted-by":"crossref","first-page":"77","DOI":"10.17340\/jkna.2020.2.1","article-title":"2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke","volume":"38","author":"Ko","year":"2020","journal-title":"J Korean Neurol Assoc"},{"key":"2026071504550705000_svn-2026-005132v1.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026071504550705000_svn-2026-005132v1.19","doi-asserted-by":"crossref","first-page":"41","DOI":"10.18700\/jnc.240044","article-title":"Principle of intravenous fluid therapy in the neurocritically ill patients","volume":"17","author":"Ko","year":"2024","journal-title":"J Neurocrit Care"},{"key":"2026071504550705000_svn-2026-005132v1.20","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.511162"},{"key":"2026071504550705000_svn-2026-005132v1.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804656"},{"key":"2026071504550705000_svn-2026-005132v1.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-023-03370-9","article-title":"Prognostic value of contrast staining on dual-energy CT after endovascular therapy in acute ischemic stroke: a meta-analysis","volume":"23","author":"Yang","year":"2023","journal-title":"BMC Neurol"},{"key":"2026071504550705000_svn-2026-005132v1.23","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6345"},{"key":"2026071504550705000_svn-2026-005132v1.24","doi-asserted-by":"crossref","first-page":"3840","DOI":"10.1007\/s00330-023-10432-6","article-title":"Prediction of cerebral hemorrhagic transformation after thrombectomy using a deep learning of dual-energy CT","volume":"34","author":"Heo","year":"2024","journal-title":"Eur Radiol"},{"key":"2026071504550705000_svn-2026-005132v1.25","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2025.103197","article-title":"Interaction of brain imaging features and effects of intensive blood pressure lowering after endovascular treatment for acute ischaemic stroke: the pre-specified secondary analyses of ENCHANTED2\/MT trial","volume":"83","author":"Zhang","year":"2025","journal-title":"EClinicalMedicine"},{"key":"2026071504550705000_svn-2026-005132v1.26","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1161\/STROKEAHA.125.051696","article-title":"Association Between Intravenous Antihypertensives and Functional Outcome After Successful Endovascular Thrombectomy","volume":"56","author":"Jung","year":"2025","journal-title":"Stroke"},{"key":"2026071504550705000_svn-2026-005132v1.27","doi-asserted-by":"crossref","first-page":"e2385","DOI":"10.1212\/WNL.0000000000201173","article-title":"Association of Contrast Enhancement After Reperfusion With Outcomes According to Blood Pressure Lowering in Patients With Acute Ischemic Stroke","volume":"99","author":"Ma\u00efer","year":"2022","journal-title":"Neurology"}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2026-005132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:55:15Z","timestamp":1784116515000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2026-005132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":27,"alternative-id":["10.1136\/svn-2026-005132"],"URL":"https:\/\/doi.org\/10.1136\/svn-2026-005132","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"value":"2059-8688","type":"print"},{"value":"2059-8696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]}}}